Hyperbaric Chamber Access, Difficulties and Major Diabetic Foot Amputation: Hyperbaric Chamber and Diabetic

Abstract

Diabetes mellitus (DM) is a chronic systemic disease that affects around 15.8 million people in Brazil. Diabetic-related vascular complications, such as major and minor amputations, constitute a significant challenge in medicine. The aim of the present study was to evaluate the incidence of lower limb amputations in patients with diabetic foot undergoing treatment with a hyperbaric chamber. The medical records of all diabetic patients with foot lesions who were indicated for hyperbaric oxygen therapy at a teaching hospital were evaluated in a cross-sectional study. Sex, age, number of hyperbaric chamber sessions and major amputations were recorded. One of the basic aims of treatment was to achieve full granulation without leaving the tendons exposed. Participants underwent local hyperbaric oxygen therapy at a pressure of 2.5 atmospheres (exposures of 30 minutes each) once a day for five days per week. The data were entered into an Excel spreadsheet and statistical analysis was performed using the Stats Direct program. The study was approved by the Research Ethics Committee of the institution. Eighty women and 203 men receiving hyperbaric oxygen therapy were evaluated (chi-square test: p-value <0.001). The mean ages of the male and female patients were 58.38 and 57.01 years, respectively (unpaired t-test; p-value = 0.4). The men received 10,014 sessions (mean: 50.07/man) and the women had 3082 sessions (mean: 41.64/woman). Thirty (10.63%) major amputations were performed in three months of follow-up; 26 (12.8%) in men and 14 (17.5%) in women. The diabetic foot is a challenge in daily medical practice. Strategies using techniques that accelerate healing, such as hyperbaric oxygen therapy, have not reduced the mortality rate of these patients, nor eliminated the possibility of amputation, but can reduce the number of major amputations.